Effect of attachment type on load distribution to implant abutments and the residual ridge in mandibular implant-supported overdentures

Impact of implant location on load distribution of implant-assisted removable partial dentures: a review of in vitro model and finite-element analysis studies

BACKGROUND

Appropriate load distribution among the supporting elements is essential for the long-term success of implant-assisted removable partial dentures; however, there is little information available on load distribution.

PURPOSE

This study aimed to evaluate the effect of implant location on load distribution in implant-assisted removable partial dentures by reviewing in vitro models and finite-element analysis studies.

MATERIALS AND METHODS

English-language studies which examined the load distribution of implant-assisted removable partial dentures and were published between January 2001 and October 2022 were extracted from PubMed, ScienceDirect, and Scopus online databases, and manual searching. Two reviewers selected the articles based on the predetermined inclusion and exclusion criteria, followed by data extraction and analysis.

RESULTS

Forty-seven studies were selected after evaluating the titles and abstracts of 264 articles; two were identified manually. After screening the text, 12 studies were included: six in vitro model experiments and six finite-element analysis studies. All included studies used a mandibular free-end missing model (Kennedy Class I or II). The influence of implant location on load distribution to the abutment tooth, implant, and mucosa under the denture base was summarized in three cases: implant at the premolar, first molar, and second molar region. Due to differences in the measurement method of load distribution and loading condition to the denture, the results differed among the studies.

CONCLUSIONS

The implant location in implant-assisted removable partial dentures can affect load distribution to the supporting elements, such as the abutment tooth, implant, and mucosa under the denture base.

Effect of different implant configurations on biomechanical behavior of full-arch implant-supported mandibular monolithic zirconia fixed prostheses

Mechanical failure of zirconia-based full-arch implant-supported fixed dental prostheses (FAFDPs) remains a critical issue in prosthetic dentistry. The option of full-arch implant treatment and the biomechanical behaviour within a sophisticated screw-retained prosthetic structure have stimulated considerable interest in fundamental and clinical research. This study aimed to analyse the biomechanical responses of zirconia-based FAFDPs with different implant configurations (numbers and distributions), thereby predicting the possible failure sites and the optimum configuration from biomechanical aspect by using finite element method (FEM). Five 3D finite element (FE) models were constructed with patient-specific heterogeneous material properties of mandibular bone. The results were reported using volume-averaged von-Mises stresses (σ_VM^VA) to eliminate numerical singularities. It was found that wider placement of multi-unit copings was preferred as it reduces the cantilever effect on denture. Within the limited areas of implant insertion, the adoption of angled multi-unit abutments allowed the insertion of oblique implants in the bone and wider distribution of the multi-unit copings in the prosthesis, leading to lower stress concentration on both mandibular bone and prosthetic components. Increasing the number of supporting implants in a FAFDPs reduced loading on each implant, although it may not necessarily reduce the stress concentration in the most posterior locations significantly. Overall, the 6-implant configuration was a preferable configuration as it provided the most balanced mechanical performance in this patient-specific case.

Stress analysis of mandibular implant overdentures retained with one, two, or four ball attachments: A finite element study

BACKGROUND

The aim of this study is to compare stress patterns induced by ball attachments when used to retain mandibular overdentures supported by one, two, or four dental implants.

MATERIALS AND METHODS

In this finite element study, three 3D models were prepared to simulate mandibular implant overdentures retained by one or two or four ball attachments of 3.5 mm diameter with collar height 1.6 mm. The geometric solid models were created by commercial engineering computer-aided design package then transferred to ANSYS as set of standard ACIS text files. Vertical load of 100 N was applied on the central fossa of the right molar. Stresses were evaluated at the areas of implant and attachment components, mucosa underlying overdentures, and cortical and cancellous bone adjacent to implants.

RESULTS

The results of this study showed that the Von Mises stresses generated by the application of vertical loading varied according to the number of implants used to support the overdenture. Maximum Von Mises stress on cortical bone ranged between 1.15 and 1.77 MPa in all-studied cases. Mucosa was squeezed under the one implant model. Flexibility of the overdenture material played a significant role in distributing the load stress and deformation of all underlying structure. Caps deformation was the highest when using two implants.

CONCLUSION

With increasing the number of implants, stresses and deformations of overdenture are reduced, but implants receive greater stresses and deformations. Using two implants in the canine region showed the best results when compared with using one or four implants, except for the caps.

COMPARATIVE STRESS ANALYSIS OF LINGUALIZED AND CONVENTIONAL BALANCED OCCLUSION SCHEMES IN A FULL-ARCH FIXED IMPLANT PROSTHESIS USING FINITE ELEMENT ANALYSIS

This study compares the biomechanical behavior of a mandibular full-arch fixed implant prosthesis with four implants under lingualized and conventional balanced occlusion schemes. The acrylic resin denture was supported by four titanium cylindrical implants and connected via a titanium prosthetic rectangular bar. Orthotropic material was used for the cortical and cancellous bones. The applied loadings were vertical and bilateral: 100[Formula: see text]N on first molar and 50[Formula: see text]N on first and second premolars each. For the lingualized balanced occlusion, the loadings were applied in central fossae of the posterior teeth, whereas for the conventional balanced occlusion the loadings were applied in central fossae and buccal cusps. The maximum von-Mises stresses for the lingualized and conventional balanced schemes were 301[Formula: see text]MPa and 25[Formula: see text]MPa, respectively, and were located at the neck of the posterior implants. In the denture teeth, the highest stress was located at the beginning of the cantilever extension. In the cortical bone, according to Tsai–Wu criterion, the failure index for the lingualized balanced occlusion was 1.10 and for the conventional balanced occlusion was 0.83. Thus, the conventional balanced occlusion demonstrated more favorable stress distribution in the implants and the cortical bone than the lingualized balanced occlusion.

Influence of Number of Implants and Attachment Type on Stress Distribution in Mandibular Implant-Retained Overdentures: Finite Element Analysis

AIM:

This study aimed to compare the stresses generated by using two or four root form dental implants supporting mandibular overdentures that were retained with ball and locator attachments.

METHODS:

Under ANSYS environment, four 3D finite element models were prepared. These models simulated complete overdentures supported by two or four implants with either ball or locator attachments as a connection mechanism. The models’ components were created by CAD/CAM package then were imported to ANSYS. Load of 100 N was applied at the right premolar/molar region vertically and at an oblique angle of 110° from lingual direction.

RESULTS:

Within the conditions of this research, in all cases, it was found that cortical and cancellous bone regions were the least to be stressed. Also, the ball attachment produced higher stresses.

CONCLUSION:

Caps deformation and stresses are negligible in cases of using locator attachment in comparison to ball attachments. This may indicate longer lifetime and less repair/maintenance operations in implant overdentures retained by locator attachments. Although the study revealed that bone was insensitive to a number of implants or attachment type, it may be recommended to use two implants in the canine region than using four, where the locator attachments were found to be better.

Fiber Bragg Grating based bite force measurement

The present study reports an in vivo, novel methodology for the dynamic measurement of the bite force generated by individual tooth using a Fiber Bragg Grating Bite Force Recorder (FBGBFR). Bite force is considered as one of the major indicators of the functional state of the masticatory system, which is dependent on the craniomandibular structure comprising functional components such as muscles of mastication, joints and teeth. The proposed FBGBFR is an intra-oral device, developed for the transduction of the bite force exerted at the occlusal surface, into strain variations on a base plate, which in turn is sensed by the FBG sensor bonded over it. The FBGBFR is calibrated against a Micro Universal Testing Machine (UTM) for 0-900N range and the resolution of the developed FBGBFR is found to be 0.54N. 36 volunteers (20 males and 16 females) performed the bite force measurement test at molar, premolar and incisor tooth on either side of the dental arch and the obtained results show clinically relevant bite forces varying from 176N to 635N. The bite forces obtained from the current study for a substantial sample size, show that the bite forces increases along the dental arch from the incisors towards the molars and are found to be higher in male than in female. The FBG sensor element utilized in FBGBFR is electrically passive, which makes it a safe in vivo intra-oral device. Hence the FBGBFR is viable to be employed in clinical studies on biomechanics of oral function.